术前炎症负荷指数在预测非转移性肌层浸润性膀胱癌总生存和进展中的价值

Value of Preoperative Inflammatory Burden Index in Predicting Overall Survival and Progression in Nonmetastatic Muscle-Invasive Bladder Cancer.

作者信息

Kayar Rıdvan, Kayar Kemal, Tokuç Emre, Topaktaş Ramazan, Çiçek Muhammet, Demir Samet, Öztürk Metin

机构信息

Department of Urology, Van Training and Research Hospital, University of Health Sciences, 65090 Van, Turkey.

Department of Urology, University of Health Sciences, Haydarpasa Numune SUAM, 34668 Istanbul, Turkey.

出版信息

Arch Esp Urol. 2025 Jul;78(6):660-670. doi: 10.56434/j.arch.esp.urol.20257806.89.

DOI:10.56434/j.arch.esp.urol.20257806.89

PMID:40776864

Abstract

PURPOSE

This study evaluates the prognostic significance of the inflammatory burden index (IBI) and related systemic inflammatory markers, namely, C-reactive protein-to-albumin ratio (CAR), systemic immune-inflammation index (SII), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic inflammation response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), and pan-immune inflammation value (PIV), in predicting survival outcomes in patients with nonmetastatic muscle-invasive bladder cancer (MIBC) undergoing radical cystectomy (RC).

METHODS

A total of 115 patients treated between January 2014 and January 2023 were included. IBI, CAR, SII, PLR, MLR, SIRI, NLR, and PIV were calculated. Kaplan-Meier, Cox regression, and receiver operating characteristic (ROC) curve analyses were performed to determine the impact of these biomarkers on overall survival (OS) and progression-free survival (PFS).

RESULTS

ROC analysis for OS prediction revealed the highest predictive accuracy for PIV (area under curve (AUC) = 0.784, < 0.001), followed by SIRI (AUC = 0.751) and IBI (AUC = 0.747). For PFS prediction, IBI demonstrated the strongest predictive value (AUC = 0.672, = 0.002), followed by CAR (AUC = 0.663, = 0.003) and PIV (AUC = 0.662, = 0.003). Multivariate Cox regression analysis identified PIV (hazard ratio (HR) = 3.673, < 0.001), SIRI (HR = 3.074, < 0.001), and IBI (HR = 2.209, = 0.002) as independent predictors of OS. High IBIs were significantly associated with advanced tumor stage (T stage) ( = 0.025), lymphovascular invasion ( = 0.002), and perineural invasion ( = 0.023) but not with lymph node metastasis ( = 0.713).

CONCLUSIONS

IBI and associated hematological markers are valuable for predicting survival outcomes in patients with MIBC. The findings support the integration of these biomarkers with other prognostic tools to enhance the accuracy of treatment outcome predictions.

摘要

目的

本研究评估炎症负荷指数（IBI）及相关全身炎症标志物，即C反应蛋白与白蛋白比值（CAR）、全身免疫炎症指数（SII）、血小板与淋巴细胞比值（PLR）、单核细胞与淋巴细胞比值（MLR）、全身炎症反应指数（SIRI）、中性粒细胞与淋巴细胞比值（NLR）以及全免疫炎症值（PIV），在预测接受根治性膀胱切除术（RC）的非转移性肌层浸润性膀胱癌（MIBC）患者生存结局中的预后意义。

方法

纳入2014年1月至2023年1月期间接受治疗的115例患者。计算IBI、CAR、SII、PLR、MLR、SIRI、NLR和PIV。进行Kaplan-Meier分析、Cox回归分析和受试者工作特征（ROC）曲线分析，以确定这些生物标志物对总生存期（OS）和无进展生存期（PFS）的影响。

结果

OS预测的ROC分析显示，PIV的预测准确性最高（曲线下面积（AUC）=0.784，P<0.001），其次是SIRI（AUC = 0.751）和IBI（AUC = 0.747）。对于PFS预测，IBI显示出最强的预测价值（AUC = 0.672，P = 0.002），其次是CAR（AUC = 0.663，P = 0.003）和PIV（AUC = 0.662，P = 0.003）。多因素Cox回归分析确定PIV（风险比（HR）=3.673，P<0.001）、SIRI（HR = 3.074，P<0.001）和IBI（HR = 2.209，P = 0.002）为OS的独立预测因素。高IBI与晚期肿瘤分期（T分期）（P = 0.025）、淋巴管浸润（P = 0.002）和神经周围浸润（P = 0.023）显著相关，但与淋巴结转移无关（P = 0.713）。